Peds: PrepU Ch. 7
A nurse is reading a journal article about adolescents and major causes of injuries in this age group. The nurse demonstrates understanding of this information by identifying which situation as the major cause of adolescent injuries? -Drowning -Motor vehicle crashes -Violence -Suicide
Motor vehicle crashes Although drowning, violence, and suicide are causes of adolescent injury, the largest number of adolescent injuries are due to motor vehicle crashes.
The nurse is caring for a 13-year-old girl. The child has been identified as overweight with no underlying psychological or secondary causes. The nurse is reviewing the child's weight-loss progress and nutrition at a follow-up visit. What finding indicates a need for further discussion and teaching? -"My daughter is helping us plan our family's weekly menu." -"We are using family outings and activities as a reward for weight loss." -"Her goal is to be a size smaller by our vacation in two weeks." -"Our whole family has changed our eating habits."
"Her goal is to be a size smaller by our vacation in two weeks." The mother must be reminded that a successful weight loss program emphasizes long-term permanent changes, not rapid weight loss or short-term diets to meet a short-term goal.
Nurses should provide anticipatory guidance to males to prepare them for what particular pubertal change in late adolescence? -Nocturnal emissions -Lengthening of the penis -Reddening of the scrotum -Breast enlargement
Nocturnal emissions This involuntary ejaculation during the night can be disturbing to the adolescent male who has little or no understanding of what is happening in his body. Lengthening of the penis begins to occur in early adolescence as does reddening of the scrotum. Breast enlargement occurs in some males in middle adolescence and resolves in late adolescence.
A black adolescent male has been diagnosed with hypertension. Which statement made by the adolescent indicates to the nurse that additional teaching is needed? -"My blood pressure should remain less than 130/90 mm Hg." -"Playing baseball is good exercise for me." -"Drinking sodas is not related to my blood pressure." -"My dad has hypertension, so I have to be careful."
"Drinking sodas is not related to my blood pressure." Hypertension is present if the blood pressure is above the 95th percentile, or 127/81 mm Hg for 16-year-old girls and 131/81 mm Hg for 16-year-old boys for two consecutive readings. Adolescents who are obese, who are black, who eat a diet high in salt, or who have a family history of hypertension are most susceptible to developing the condition. Drinking soda regularly increases the amount of sodium intake daily, thus having an impact on the blood pressure.
The nurse is providing anticipatory guidance to the parents of a 15-year-old who voice concerns with their teenager's sleep habits. They state, "Left to her own devices, I'm sure she'd stay up until 3:00 in the morning on the weekends and sleep until after lunchtime." Which should the nurse explain to the parents? -"I can hear that this is exasperating for you, but know that children do grow out of this in time, with no ill effects." -"That must be hard for you to manage. Perhaps we can explore some strategies with her to establish more predictable sleep patterns." -"This is expected at this stage of development. Are there any ways that you could adjust your family routines to accommodate this?" -"It's very important that you communicate to your daughter that this is unacceptable because it can have a negative effect on her health."
"That must be hard for you to manage. Perhaps we can explore some strategies with her to establish more predictable sleep patterns." It is common for adolescents to adopt habits of going to bed late and awakening late, especially on weekends. Despite the fact that this is common, it is not ideal; the nurse should explore strategies for changing the adolescent's behavior in a collaborative and inclusive manner. Simply communicating that it is unacceptable is unlikely to bring about change.
A 15-year-old client's parent comments on the fact that the adolescent seems to always choose the opposite of what everyone else wants and that mood swings are a common occurrence. What statement shows the nurse that the client's parent understands these changes? -"I know that my adolescent is doing this because of all the hormones." -"This is common for this age group and it will get better with time." -"This is my adolescent's temperament, and we will have to learn how to deal with it." -"My adolescent will never find anyone to live with if the adolescent acts like this."
"This is common for this age group and it will get better with time." During middle adolescence, the adolescent spends more time ignoring adult authority and becomes more reliant on peer relationships. Adolescents might choose a stance directly opposite that of their parents and use peer support to back their ideas. Mood swings are a common occurrence during the adolescent period. They tend to smooth out and the adolescent will become more introspective. By late adolescence emotions become more consistent. Making statements such as "my adolescent will never find anyone to live with" or "we will have to learn to live with [my adolescent's temperment]" does not demonstrtae the parent has a good idea of what is happening during the adolescent period.
An adolescent who is depressed states, "Nothing ever seems to be right in my life." Which would be the most appropriate response by the nurse? -"Things will be better when you go off to college." -"You are feeling sad right now. It's a hard time." -"Try to look at the bright side of things." -"Being a teenager is hard work."
"You are feeling sad right now. It's a hard time." Some degree of depression is present in most adolescents because they are not only losing their parents while they grow apart from them but also their carefree childhood. When using therapeutic communication, it is important for the nurse to accept the client's verbalization as real. Support should be real. Telling the adolescent that things will be better in college provides false reassurance. Telling the adolescent to "look on the bright side of things" or that "being a teen is hard work" offer platitudes and interrupt the client's interactions.
During the assessment of a 15-year-old female the nurse notes a new body piercing in the navel. Which statements by the nurse would be appropriate in regard to this new piercing? -"You are very young to have a navel piercing. Do your parents know you have this?" -"I really like your belly ring. Where did you get it?" -"I notice you have a new piercing. Be sure to clean it twice a day so you don't get an infection." -"Did they tell you when you got your piercing how important cleaning it is? Infections can take up to a year to heal in a naval piercing." -"A navel piercing is a lot better than a tattoo. At least the piercing doesn't have to be permanent if you don't want it to be."
-"I notice you have a new piercing. Be sure to clean it twice a day so you don't get an infection." -"Did they tell you when you got your piercing how important cleaning it is? Infections can take up to a year to heal in a naval piercing." Informing the client about infection risks and prevention are appropriate responses by the nurse when noticing a new body piercing. Judgmental responses and personal responses are not appropriate from the nurse.
For reasons of anticipatory guidance, nurses should be aware that menarche appears earlier in some ethnic groups than others. In which ethnic group is menarche likely to appear first? -Black -White -Hispanic -South Asian
Black Black girls on average reach menarche slightly earlier than White, Hispanic, and South Asian girls.
The school nurse is providing nutritional guidance to a 9th-grade health class. Which foods should the nurse recommend as good sources for calcium? -Strawberries, watermelon, and raisins -Beans, poultry, and fish -Peanut butter, tomato juice, and whole grain bread -Cheese, yogurt, and white beans
Cheese, yogurt, and white beans Cheese, yogurt, white beans, milk, and broccoli are good sources of calcium. Strawberries, watermelon, raisins, peanut butter, tomato juice, and whole grain bread are all foods high in iron.
A 17-year-old adolescent chats excitedly with the nurse about plans for college and a career. The adolescent states having checked out every college in the region and determined which one is the best fit and would give the adolescent the best career options. The nurse recognizes which developmental aspect in this client? -Formal operational thought -Socialization -Identification of identity -Sensorimotor
Formal operational thought The final stage of cognitive development, the stage of formal operational thought, begins at age 12 or 13 years and grows in depth over the adolescent years, though it may not be complete until about 25. This step involves the ability to think in abstract terms and use the scientific method (deductive reasoning) to arrive at conclusions. With the ability to use scientific reasoning, adolescents can plan their future. They can create a hypothesis (What if I go to college? What if I do not?) and think through the probable consequences (In the long run, I will earn more money; I could begin earning money immediately). This scenario does not pertain to socialization, role identification, or sensorimotor development.
The nurse is meeting with a group of caregivers of adolescents. Which example should the nurse point out is most effective for the caregiver to support the adolescent? -Leave pamphlets about topics such as drugs and alcohol in their room so they can read them. -Let them choose their hairstyle, even though it may not look the best for them. -Discourage spending too much time with school friends since we know they can be a negative influence. -Our house rules are stricter than their friends but everyone follows the same rules in our home.
Let them choose their hairstyle, even though it may not look the best for them. The adolescent whose family caregivers make it difficult to conform are adding another stress to an already emotion-laden period. By allowing the adolescent to follow trends and fads in clothing choices, hairstyles, and music, the caregiver decreases the stress for the child. Information about drugs and alcohol is important to share, but these topics would be better discussed with the child. It is important the adolescent spend time with peers.
The school nurse is preparing health promotion presentations regarding unintentional injuries for a high school health fair. On which topic should the nurse place as the priority when preparing the presentation? -Poison prevention -Water sports injuries -Motor vehicle safety -Drug and alcohol use prevention
Motor vehicle safety All options should be included in the presentation, but motor vehicle safety has the highest priority because motor vehicle accidents are the leading cause of injury and death followed by poisoning, which includes prescription drug overdose.
A 16-year-old client has been hospitalized 100 miles from home for 1 week to repair a fractured patella suffered in a skateboarding accident. She was cheerful and chatty when she first arrived, but the nurse notes in recent days she has become increasingly quiet and seems lonely. Which nursing intervention should the nurse prioritize for this client? -Call the hospital's mental health unit to see if she can get some counseling. -Take her to the teen lounge so she can meet other teens, use a phone, and check her e-mail. -Suggest that she read books and magazines from the hospital bookmobile. -Ask her caregivers to bring her siblings and friends to visit.
Take her to the teen lounge so she can meet other teens, use a phone, and check her e-mail. Adolescents need access to their peers so they can keep up social contacts. Access to a phone, computer, and e-mail will help the teen stay connected. Recreation areas are important. In settings specifically designed for adolescents, recreation rooms can provide an area where teens can gather to do schoolwork, play games and cards, and socialize. Because she is 100 miles from home, a visit from friends might be difficult.
The nurse is preparing to participate in a community discussion on the needs of the adolescents in the local school. The nurse should point out which goal is the primary concern for these young individuals as the committee makes plans? -Teens are busy developing their own personal identity. -They want to successfully complete activities. -Each child is learning to do things on his or her own. -They understand and respond to discipline.
Teens are busy developing their own personal identity. According to Erikson, the central task of adolescence is to develop unique personality and identity. The developmental task for the school-age child is to develop a sense of industry, and completing activities builds that feeling of confidence. Erikson's psychosocial developmental task for toddlers is to achieve autonomy (independence) and do things on their own. Learning to speak and to understand and respond to discipline are not developmental tasks, according to Erikson.
The physician has made a notation in the medical record of a 17-year-old that the teen is not demonstrating successful completion of Erikson's stages of development. What behavior would be consistent with this assessment? -The teen is distrustful of others. -The teen is anxious to move away from his parent's home. -The teen is sexually promiscuous. -The teen is uncertain and frequently unable to make decisions.
The teen is uncertain and frequently unable to make decisions. According to Erikson's stages of development, the teen develops a sense of identity. Failure to successfully complete this stage will result in a lack of self confidence and an inability to see one's self as in independent being. The establishment of the ability to trust is completed in an earlier stage of psychosocial development. A desire to move away from the parental home is not uncommon and is not a sign of impaired navigation of this level of psychosocial development.
A 15-year-old adolescent is seen at a health care facility for facial acne. When counseling the teen, the nurse would teach that the basic cause of acne is: -lack of showering adequately after gym class. -activation of androgen hormones. -vitamin deficiency from an inadequate diet. -thyroid-gland secretions increasing with adolescence.
activation of androgen hormones. Acne occurs in adolescence as the result of hormone influence. With increased androgen production the sebaceous glands become more active. With increased testosterone production (in both boys and girls) increased sebum is produced. These increased hormone productions leads to the development of acne. Showering will certainly lead to a cleaner skin and the removal of oils but the lack of showering does not cause acne. Diet and thyroid hormones do not play a role in the development of acne.
The nurse is counseling an overweight, sedentary 15-year-old girl. The nurse is assisting her to make appropriate menu choices. Which statement indicates the adolescent understands how to make appropriate dietary selections? -"I avoid all fat intake." -"Because of my age, my dairy intake is unlimited." -"I need to have 4 servings of fruit each day." -"To lose weight my protein intake should be limited to 2 to 4 servings per day."
"I need to have 4 servings of fruit each day." The sedentary teen needs to consume approximately 1,600 calories each day. The recommended number of daily servings of fruit is four. A balanced diet includes a small amount of fat. To avoid all fat could place the child's health at risk. Protein intake is important for the development of tissue. The teen will need about 5 ounces of protein daily.
The nurse is caring for adolescent athlete who is being seen for a fractured arm. The parent reports that this is the third sports injury in the past 2 years. The parent asks the nurse why the adolescent who is healthy overall continues to have injuries. How should the nurse respond? -Some adolescents are accident prone. -There may be some underlying problems that your adolescent should be evaluated for. -The bones, joints and tendons of adolescents are vulnerable to injury due to their rapid state of growth. -These are accidents and random in occurrence.
The bones, joints and tendons of adolescents are vulnerable to injury due to their rapid state of growth. Rapidly growing bones, muscles, joints, and tendons are more vulnerable to unusual strains and fractures. While some people may seem to be accident prone, this adolescent's injuries are most likely the result of the stage of physical growth. There is no evidence the adolescent has any underlying medical conditions.
The school nurse is meeting with a group of 11-year-old girls to discuss expected puberty changes in their bodies. When one of the girls states, "I just feel like my whole body is changing and I don't know why" what should the nurse point out to this group? -"You will feel better about yourself as you get older." -"You have lots of hormone changes going on right now." -"You may feel like you are changing, but you still look the same." -"Your other friends are feeling like this too."
"You have lots of hormone changes going on right now." Preadolescents need information about their changing bodies and feelings. Sex education that includes information about the hormonal changes that are occurring or will occur is necessary to help them through this developmental stage. Although adjustments will occur as the child gets older and friends are important, these responses are not the most direct and appropriate.
A 17-year-old female is meeting with the nurse for an annual well-visit and is asking the nurse questions about how to know when one is in love. The nurse should point out which factor to help decide if both individuals have reached a mutual agreement and are ready for an intimate relationship? -A sense of trust and identity -An ability to be autonomous -A willingness to take initiative -An understanding of socialization and of isolation
A sense of trust and identity In order to be intimate or to share one's deepest feelings with another person, it is impossible unless both persons have established a sense of trust and a sense of identity. Being autonomous or taking initiative are not aspects that lead toward intimate relationships. Socialization and isolation are not relevant to the establishment of intimate relationships.
A nurse is explaining cognitive development in children to a client, with the help of Piaget's theory of cognitive development. What would be the best explanation by the nurse about the formal operations level of cognitive development? -Up to age 2, children learn by touching, tasting, and feeling. They learn to control body movement. -Children from ages 2 to 7 years investigate and explore the environment and look at things from their own point of view. -From ages 7 to 11 years, children internalize actions and can perform them in the mind. -After age 12 children can think in the abstract, including complex problem solving.
After age 12 children can think in the abstract, including complex problem solving. The nurse should explain that there are four levels of cognitive development in Piaget's theory. The sensorimotor level is up to age 2 where children learn by touching, tasting, and feeling. They learn to control body movement. Preoperational level is children from ages 2 to 7 years who investigate and explore the environment and look at things from their own point of view. At the concrete operations level from ages 7 to 11 years, children internalize actions and can perform them in the mind. At the formal operations after the age 12 children can think in the abstract. Complex problem solving is included in this category.
The school nurse is assessing a 16-year-old girl who was removed from class because of disruptive behavior. She arrives in the nurse's office with dilated pupils and is talking rapidly. Which drug might she be using? -Opiates -Barbiturates -Amphetamines -Marijuana
Amphetamines Amphetamine use manifests as euphoria with rapid talking and dilated pupils. Signs of opiate use are drowsiness and constricted pupils. Barbiturates typically cause a sense of euphoria followed by depression. Marijuana users are typically relaxed and uninhibited.
The nurse is assessing an adolescent's risk for harm from guns being present in the home. What question would be best to ask during the assessment? -"Have you been taught how to use a gun?" -"Are the guns in your home locked in a safe?" -"Do you understand that it is important for you not to handle a gun?" -"Do you and your dad hunt?"
"Are the guns in your home locked in a safe?" Common causes of death in adolescents are homicide and self-harm. These are related to the easy accessibility of guns, especially when added to depression, binge drinking, and impulsivity. Gang violence and the desire to protect themselves are additional factors. Having the gun locked in a safe provides a way for limited access. Knowing how to use a gun and going hunting demonstrate expertise, but the safest way to prevent harm is to have the gun locked when not in use for these purposes. Telling the adolescent it is important not to use a gun provides no explanation why and comes across as a rule to be broken.
A 16-year-old adolescent is talking with the nurse at a local health clinic about skin care. Which comments by the teen does the nurse determine require additional conversation? Select all that apply. -"I only tan before going on spring break to get a base tan so I won't burn." -"My mom had melanoma so she always makes me wear a sunscreen with an SPF of 30." -"My favorite time of day to be outside is the middle of the day, around noon." -"Our coach makes us wear sun-protective clothes when we practice outside on the weekends." -"The more exposure and burns I get now will toughen my skin so I won't get skin cancer when I'm older."
-"I only tan before going on spring break to get a base tan so I won't burn." -"My favorite time of day to be outside is the middle of the day, around noon." -"The more exposure and burns I get now will toughen my skin so I won't get skin cancer when I'm older." The nurse should further discuss comments that demonstrate incorrect information about sun exposure. Any exposure to tanning beds should be avoided to prevent skin cancer risks. Other risks for skin cancer include being in the sun between the times of 10:00 am and 4:00 pm, and sun exposure and burns during childhood and adolescence. A minimum SPF of 15 should be used, so SPF 30 is good practice, as is wearing sun-protective clothing when outside during the day.
A client has confided in a nurse that her 13-year-old daughter has recently changed dramatically in her social interactions with others. What is a social behavior most likely to be exhibited by a girl at this age? -Banding together with other girls and dressing like them -Banding together with boys and girls but maintaining her own unique style -Hanging out primarily with boys her own age -Hanging out with girls but maintaining her own unique style
Banding together with other girls and dressing like them In early adolescence, girls tend to band together with girls. They dress identically with other members of their group: jeans and sweatshirts, special jackets, or whatever the fashion may be. On the surface, this makes adolescents appear to be losing their identities rather than finding them.
The parents of a 16-year-old male are worried about recent changes in his behavior, ignoring his schoolwork and sports, and spending almost all of his free time interacting with his girlfriend. Which suggestion should the nurse point out would best address this situation? -He is not developmentally mature enough to make healthy choices about the ways in which he spends his time, so it would be helpful if they would make a schedule for him that includes about a half-hour per day to talk with his girlfriend. -He has developed his own identity by now; being able to establish close relationships with girls is important preparation for all of his adult relationships. They should honor his need to be with, or talk to, his girlfriend as long as he has completed his schoolwork for the day. -He is not developmentally mature enough to have an intimate relationship with one girl; they should encourage him to spend time with groups of friends rather than time alone with his girlfriend. -He has chosen a girl who is overly dependent on him. They should talk to him about making sure he meets his own needs, including doing the schoolwork he enjoys, in any relationship.
He has developed his own identity by now; being able to establish close relationships with girls is important preparation for all of his adult relationships. They should honor his need to be with, or talk to, his girlfriend as long as he has completed his schoolwork for the day. When identity has been established, generally between the ages of 16 and 18 years, adolescents seek intimate relationships, usually with members of the opposite sex. Intimacy, which is mutual sharing of one's deepest feelings with another person, is impossible unless both persons have established a sense of trust and a sense of identity. Intimate relationships are a preparation for long-term relationships, and people who fail to achieve intimacy may develop feelings of isolation and experience chronic difficulty in communicating with others.
A female client tells the nurse about noticing an increase in weight and fat deposits during the past year. The nurse reviews the client's chart and recognizes that the client is most likely going through puberty. Which nursing action is most appropriate at this time? -Provide reassurance that these are normal changes. -Review dietary measures to assist in controlling weight gain. -Encourage increased exercise to control weight gain. -Share what foods can be eaten on a low-fat diet to prevent fat deposits.
Provide reassurance that these are normal changes. Increased fat deposits and weight and height changes are normal as girls begin hormonal changes of puberty. During adolescence, girls are very sensitive about their appearance and experience a constant need for reassurance. Puberty is a period when children are very self-conscious about their overall appearance. Reassurance needs to be provided that increased fat deposits and weight and height changes are normal. Dietary management is indicated if a true weight problem is present, but healthy eating should be encouraged rather than dieting. Adolescents should be encouraged to participate in appropriate exercise programs. Dieting issues such as anorexia and bulimia can threaten the health of adolescents.
An adolescent's parent states not knowing what to do with the adolescent. The parent reports the teenager is taking two or three showers a day when not that long ago the parent could barely get the teen to take a shower at all. What should the nurse's reply be to the parent? -"Reinforce the family rules but also allow the adolescent to develop one's own routine." -"Remind the adolescent about needing to be on a schedule so as to not disrupt the family." -"Do not encourage multiple baths; it can be very drying to the skin." -"Reevaluate the adolescents's ability to perform hygiene care since showering is so frequent."
"Reinforce the family rules but also allow the adolescent to develop one's own routine." Adolescents find that frequent baths and deodorants are important due to the apocrine sweat gland secretion activity. The increases in sex hormones and steroids cause the skin to be oily. This leads to more showers or baths daily. This is a time when the adolescent is defining what type of personal hygiene products are preferred. Hygiene and personal care can become a source of family arguments as the young person develops a style of personal care. Parents need to be mindful of the adolescent yet maintain family rules and boundaries regarding aspects of personal care. It is important for teenagers to feel that they have some ability to develop their own personal care standards and daily patterns.
The mother of a 15-year-old boy expresses sadness to the nurse that her son is "much more connected to his friends than his family." What understanding would benefit this parent? Select all that apply. -Peers are needed for emotional security while stepping away from family. -Peers provide opportunity to learn and practice social roles. -Peers can be positive or negative influences. -Adolescents need parental support and guidance as they move toward greater peer involvement. -Parents should wait until the adolescent introduces them to their peers.
-Peers are needed for emotional security while stepping away from family. -Peers provide opportunity to learn and practice social roles. -Peers can be positive or negative influences. -Adolescents need parental support and guidance as they move toward greater peer involvement. The parent should understand that at this stage of development, it is normal for peers to have a large role in the adolescent's life. The adolescent is finding his/her place outside the home filling a need for emotional security, an opportunity to learn and practice societal roles. It is true that peers can have a positive influence or a negative influence over the adolescent. Adolescents still need their parents involvement in their life with support and guidance. The parents should take a proactive approach at getting to know their adolescent's peers.
The nurse is meeting with a group of caregivers of adolescents and discussing sex and sexuality, including how to discuss these issues with their children. Which comment should the nurse prioritize with this group of caregivers? -Teenagers spend so much time with their peers, and that is usually how they find out about sex. -Being honest and straightforward with teenagers will encourage them to ask about subjects like sexuality. -Most schools have excellent programs to teach adolescents about sex and sexuality. -Internet resources, movies, and television have the most accurate and current information for your adolescent to learn about sexuality issues.
Being honest and straightforward with teenagers will encourage them to ask about subjects like sexuality. The most important aspect of discussions about sexuality with adolescents is giving honest, straightforward answers in an atmosphere of caring concern. Children whose need for information is not met through family, school, or community programs will get the information—often inaccurately—from peers, movies, television, or other media.
A nurse is attending to a group of boys at a school. The nurse is required to document the sexual development in boys on a regular basis. The nurse would anticipate which clients having the highest incidence of nocturnal emissions? -Clients who have reached adulthood -Clients in the age group of 18 to 20 years -Clients who are showing pubertal changes -Clients with strong, muscular appearance
Clients who are showing pubertal changes The nurse should know that boys who are undergoing pubertal changes are more likely to experience nocturnal emissions. The first sign of pubertal changes and sex maturation is testosterone secretion. As this increased so does the penis and scrotum enlargement. This is a time when nocturnal emissions occur. In late adolescence, which lasts from age 18 to 20, the transition into adulthood is completed. The nurse should also know that boys in the age group of age 12 to 20 experience various chemical and physical changes taking place within their body. A strong, muscular appearance does not indicate the presence of nocturnal emissions.
A 15-year-old adolescent shows a pattern of gaining weight, not a large amount but a little more each visit. The adolescent is not active in any sports and eats out frequently with parents. What is the best way for the nurse to assess the adolescent's eating pattern? -Ask the adolescent to recall what was eaten in the last 3 days. -Have the adolescent guess the calorie intake in a 24-hour period. -Have the adolescent keep a food diary for 1 week. -Ask the adolescent to show the nurse what a healthy portion looks like.
Have the adolescent keep a food diary for 1 week. Having the adolescent keep a food diary over 1 week allows the nurse as well as the client to examine what the client eats and when the client is eating it. Keeping a food journal allows a discussion of the choices made and the substitutes that the client could possibly make. The times that the client eats may also lead to weight gain. Asking for recall of 3 days' intake would be difficult, and most information would be inaccurate due to forgetting some item of food intake or when the food was eaten. Most people have no idea how many calories are in a food item unless they are specifically counting calories for dieting or health reasons. An adolescent would have a difficult time demonstrating a healthy portion size unless it has been demonstrated first.
True adolescence is said to begin when what occurs? -Sperm is produced in the male. -The areola separate from the contour of the breasts in the female. -The voice deepens in the male. -The growth spurt in the female ends.
Sperm is produced in the male. True adolescence begins with the onset of menstruation in the female and the production of sperm in the male. In early adolescence (10 to 13 years) the female experiences the first menstrual cycle and the male experiences growth of the testes. In middle adolescence (14 to 16 years) the female aerola and papilla separate from the contour of the breast to form a mound and the male testes and scrotum grow and the voice changes. In late adolescence (17 to 20 years) breast enlargement stops in the female and the male achieves adult size penis and scrotum. The growth spurt in the female adolescent ends about 2 to 2.5 years after menarche. For boys it occurs around age 14 years.
An 18-year-old adolescent reveals the presence of nipple ring and is looking to get a tattoo in the next few months. What is the most important thing that the nurse can teach the adolescent at this time? -Complications are more likely when you tattoo yourself. -Review the safety rules for those who do the tattooing. -Tattooing carries risks such as infection, disease, and nerve damage. -It is not recommended to get the tattoo from your friend in his garage.
Tattooing carries risks such as infection, disease, and nerve damage. The nurse needs to emphasize that tattoos and body piercing can be painful, and carry risks of complications such as infection, blood-borne diseases, keloids and granulomas, allergic reactions, excessive bleeding, nerve damage, or damage to the piercing site. Complications are more likely if a person tattoos oneself or has the tattoo done by a friend. The nurse needs to encourage the adolescent to seek the expertise of a trained technician, doctor, or nurse to have the piercing, tattooing, or branding done. There are developed safety rules for those who do piercing and tattoos.
According to Erikson, the adolescent develops his or her own sense of being an independent person with individual thoughts and goals. This stage is referred to as: -identity vs. role confusion. -autonomy vs. doubt and shame. -industry vs. inferiority. -intimacy vs. isolation.
identity vs. role confusion. Adolescents must develop their own personal identity—a sense of being independent people with unique ideals and goals. This is the period Erickson calls identity versus role confusion. Erickson believes during this time the adolescent goes back through all previous developmental periods to achieve this identity. The stage of autonomy versus shame and doubt occurs between 18 months and 3 years. Industry versus inferiority occurs between 5 to 12 years. Intimacy versus isolation occurs in adulthood between the ages of 19 to 40 years.
The mother of a 13-year-old boy confides to the pediatric nurse practitioner that her son has recently had a nocturnal seminal emission. The mother is concerned, and the nurse explains "wet dreams" and the other male traits of puberty to the mother. Which response indicates a need for further discussion? -"My son must be sexually active or having overly sexual thoughts to have a nocturnal emission." -"My son's spontaneous erections and nocturnal emissions are very normal." -"My son is not doing anything to cause the nocturnal emissions; they occur spontaneously." -"My son is developing normally and the traits of puberty vary from child to child."
"My son must be sexually active or having overly sexual thoughts to have a nocturnal emission." Spontaneous erections and nocturnal seminal emissions do not mean that the child is sexually active or having overactive sexual thoughts. Parents need to be instructed that these occurrences are spontaneous and that the child is not doing anything to cause them.
The school nurse is developing a school wellness program to promote healthy eating habits and regular physical activity. Each class will be engaging in lessons, contests, and goal setting to develop healthy habits. What is the most important element to emphasize to maximize compliance and long-term change? -Eliminate sweetened, carbonated beverages in the cafeteria. -Serve only low-fat, flavored milk and real fruit juices in the cafeteria. -Incorporate physical activity as part of each child's daily school schedule. -Include both parents and children in the wellness program.
Include both parents and children in the wellness program. Every campaign to support good nutrition and daily physical activity must include parents and their children as active members of the learning community. Programs implemented without a family-centered approach are doomed to fail when the child's home life and school life are disconnected.
A 15-year-old girl is in the hospital for surgery and is confined to bed. The nurse can tell that the client is nervous about being in the hospital. She tells the nurse that she feels "gross" and "on display" in her hospital gown. What should the nurse do to encourage a sense of autonomy and dignity related to the girl's body image? -Offer to assist the girl in washing her hair and let her pick the shampoo. -Allow the girl to wear her own clothes, despite hospital policy. -Brush the girl's hair for her. -Assist the girl with using the bedpan to urinate.
Offer to assist the girl in washing her hair and let her pick the shampoo. Remember when caring for hospitalized adolescents, providing time for self-care, such as shampooing hair, is important to include in an adolescent's nursing care plan. Offering to assist the client in washing her hair and letting her pick the shampoo both encourages a sense of autonomy to the client and offers her dignity related to her body image. Brushing the girl's hair for her and assisting her with using the bed pan for urination do not encourage a sense of autonomy. If it is the hospital's policy to require clients to be dressed in a hospital gown while admitted, the nurse should not allow the girl to wear her own clothes.
The nurse is admitting a 15-year-old adolescent to the hospital pediatric unit. What does the nurse recognize as a priority for this adolescent? -The adolescent's need for privacy should be respected. -The adolescent should be encouraged to call friends often. -The adolescent's need for parental support should be discussed. -The adolescent should be given freedom to participate in unit activities as desired.
The adolescent's need for privacy should be respected. When an adolescent is ill or injured, it affects the body and body image. A hospitalized adolescent's primary concerns are pain and the loss of privacy. The adolescent is also anxious about being separated from friends and losing control of one's life. When an adolescent is hospitalized, it is very important the adolescent be given privacy. The adolescent needs individualized attention, confidentiality, and the right to participate in decisions about one's own health care. The adolescent should have contact with friends and be allowed in unit activities. Because the adolescent is under the age of 18, the parents should be involved and informed of the care. The nurse can talk with the adolescent and parents about care decisions and the adolescent's need for support from family.
